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[jasmine5]

My Gp has just prescribed Oestrogel 2 pumps daily and Utrogestan days 1 - 14.  This is quite a new regime for me as I've not tried the gel before, so my big worry is will I get a bleed after day 14?  I've exhausted most other Hrt options now so I feel this is a last resort for me.  The problem is I'm 58 now and don't want to go back to periods and all that messing about!!  My Gp didn't know much about Oestrogel at all and had never prescribed it before so therefore she couldn't really answer my concerns. 

I started yesterday with much apprehension so would be grateful for any advice please x

[Mary G]

My GP doesn't know the first thing about the menopause or HRT!  I am a patient of Professor Studd and take 2 pumps of gel everyday, a small bead of testosterone and 7 x 100mg Utrogestan (vaginally) every 5 weeks and it is working brilliantly.  I am now 55, 10 years post menopause and feel completely back to normal (which is quite rare apparently) so I must be doing something right. 

I have always hated periods so that is one drawback but they have got lighter since I cut down to 2 pumps of gel.  It is better to use Utrogestan vaginally because it has fewer side effects when taken in that way and it also works better at preventing lining build up and it should also mean (slightly) lighter periods.  I have tried continuous combined HRT in the past in an effort to avoid periods but I'm afraid the continuous progesterone not only triggers my migraines, it also takes away the feelgood factor/positive effects provided by the oestrogen.

From my personal experience of trying many different types of HRT, I think you are on the best regime and I am sure you will get on very well with it.  It is also a very flexible regime meaning you can adjust the dosage to suit your needs.  Please let us know how you get on.

[jasmine5]

Thank you for your reply.  Sorry do you mean you only take 7 capsules in five weeks?  So does this mean that you still have periods or have they now stopped?  I have no problem with using the capsules vaginally its just the bleeding I want to avoid as I know as soon as this happens I will be referred for yet another vaginal scan.  Why does everyone appear to be on different amounts of Utrogestan and what determines this, I am so confused!

You are so lucky to be under Professor Studd. I am desperate to see him but had to cancel my appointment last month as I had other issues going on.  Does the Testosterone make any difference?

x

[Trufflecat]

I am 53 and was in peri when I started HRT a year ago....for pms as I didn't have many other symptoms. I have been on the same as you but Utrogestan for 7 days and feel pretty ok. The thing  that bothers me is that I haven't had bleeds on this regeime (did on Evorel) and I wonder whether 10 days might be better

[dazned]

As I understand it your regime is a sequential one and you would/could experience a monthly bleed.

[Mary G]

jasmine5, yes, I take 7 x 100mg capsules vaginally every 5 weeks - I have stretched the cycle a bit which I can safely do because I have regular uterine scans and my last lining reading was just 2mm immediately post period.  Professor Studd prescribes less Utrogestan than the NHS but I cannot take the NHS recommended dose because I am severely intolerant to all types of synthetic progesterone and high doses of Utrogestan - it triggers migraines so I have to limit its use.  I do have a decent bleed after taking the Utrogestan (usually about 5-6 days after taking the last capsule) but this is normal when it is taken cylically.  I don't see why having a period would mean you are referred for a scan but do take up the offer, that way, you will be able to see how well it is working at lining clearance.

Trufflecat, why don't you have a scan to see how well it's working?  Chances are, the Utrogestan is doing its job at keeping your lining thin, particularly if you are taking it vaginally, and you may not have any build up.  I don't think you can guess how much Utrogestan you need, you really need to take it for a few months and then have a scan to see how well it's working.  Some women might need more and some might need less but it's better to find out rather than take the wrong dose for years on end.  How much oestrogel are you using?

[Trufflecat]

Two pumps per day Mary, thanks for asking. Been on that combo for 4 months.

[Sunnydays]

MaryG, do you think the testosterone could contribute to clearing the womb lining? I only ask this because some progesterones like Norethisterone are derived from testosterone. I could making a completely wrong connection!!

[Mary G]

Sorry for the late reply, just been watching the football!  Sunnydays, I don't know whether the testosterone would help with lining clearance, it is supposed to help with libido and strength.  I have noticed that my periods have become lighter since I started taking DHEA tablets but that could be coincidence.  One thing my gynae said was that periods do get lighter eventually even if you continue taking the same amount of oestrogen.  The problem is everyone is so different and different people need different amounts of both oestrogen and progesterone to get the same results. 

Trufflecat, you could try taking more Utrogestan to see if that gives you a bleed but I would still have a scan to find out how well it is working and to give you an idea of how much you need to be taking. 

[Trufflecat]

Thank you Mary, I might just do that in a few months.

Jasmine I give the regeime a go. I think that I am progesterone intolerant since my history of dreadful pms plus feeling great when preg would suggest that. Plus the monthly migraines.  Try it for a few months.

I have no idea why some women take Utrogestan for days 1-15 and others 14-25!

[jasmine5]

Day three and woken up again with a headache and pain around my eyes.  I dont know if its the progesterone or something else as I've been suffering with sore eyes recently.  I've just read in the Utrogestan leaflet that if you are suffering with headaches and eye problems then report to your Gp as soon as possible.  It seems every time that I try a new Hrt the side-effects outway the positives!

On a plus side I'm sleeping like a log!

x

[Hurdity]

Thank you Mary, I might just do that in a few months.

Jasmine I give the regeime a go. I think that I am progesterone intolerant since my history of dreadful pms plus feeling great when preg would suggest that. Plus the monthly migraines.  Try it for a few months.

I have no idea why some women take Utrogestan for days 1-15 and others 14-25!

The days you take progesterone are always related to the cycle - so Day 1 is always the start of the bleed, and utrogestan if taken cyclically taken from day 15 to day 26 in any 28 day cycle. In practice of course bleeds come at different times but most women continue to take HRT on a 28 day cycle.

Once you are post-menopausal you can start when you like but you always start with the oestrogen - and this would normally be Day 1 (even if there is no bleed).

What gets confusing is some gynaes saying take the utrogestan monthly (which would give 12 cycles a year not 13) and suggest taking it on the 1st to the (up to 12th) date of the calendar month - so that is not related to the traditional counting of the cycle if you see what I mean.

If starting HRT for the first time you would normally start with the oestrogen only and then take the progesterone, which would be followed by a bleed. However maybe some docs suggest doing it the other way round if the lining may already have built up or if you are still having a cycle and it fits in this way?

Hurdity x